Review of the 6 QSEN Competencies for Nursing Graduates

The Six QSEN Competencies for Nursing Graduates are a foundational framework designed to prepare nurses for modern healthcare environments. Developed through the Quality and Safety Education for Nurses (QSEN) initiative, these six core competencies—patient-centered care, teamwork and collaboration, evidence-based practice (EBP), quality improvement (QI), safety, and informatics—aim to close the gap between nursing education and practice. As healthcare systems grow increasingly complex, these competencies help ensure that new nurses are not only clinically skilled but also capable of contributing to safer, higher-quality care.

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1. Patient-Centered Care

Patient-centered care is at the heart of modern nursing practice. It involves recognizing the patient as a full partner in their care, honoring their preferences, values, and cultural needs. Instead of seeing the patient as a passive recipient, this model emphasizes shared decision-making and individualized care planning. Nurses must develop strong communication skills to advocate for patients and build trusting relationships.

Sherwood and Barnsteiner (2017) argue that nurses who practice patient-centered care are better able to reduce patient anxiety, increase adherence to treatment, and improve overall health outcomes. This competency also includes respect for diversity and sensitivity to health literacy, requiring nurses to adjust their approach based on each patient’s background and abilities.

2. Teamwork and Collaboration

No nurse works in isolation. Teamwork and collaboration are essential to delivering safe, effective care. This competency requires nurses to work cohesively with other healthcare professionals, including physicians, pharmacists, social workers, and therapists. Communication, respect for different roles, and conflict resolution are all key elements.

A lack of collaboration often results in fragmented care, medical errors, and patient dissatisfaction. Clark (2015) emphasizes that strong interprofessional communication can prevent misunderstandings and help resolve issues before they escalate. Nursing graduates must not only participate in teams but also learn to lead, guide, and influence group dynamics positively. Simulation labs and clinical rotations are valuable opportunities to build these skills.

3. Evidence-Based Practice (EBP)

EBP is the use of current, high-quality evidence combined with clinical expertise and patient preferences to make decisions about care. Nursing graduates must be prepared to question tradition and seek out the best available research. This involves identifying clinical questions, searching for credible studies, evaluating research findings, and applying them appropriately.

Melnyk and Fineout-Overholt (2019) highlight that EBP improves patient outcomes, increases nurse satisfaction, and reduces healthcare costs. For example, implementing evidence-based protocols for pressure ulcer prevention or sepsis screening has been shown to significantly improve outcomes. Nurses must be taught not only how to read the research but also how to evaluate its quality and relevance to specific patient scenarios.

4. Quality Improvement (QI)

Quality improvement involves the systematic use of data and performance metrics to drive changes in healthcare processes. Unlike EBP, which focuses on the what of care, QI focuses on how care is delivered. Nurses must be able to identify problems in systems, measure outcomes, and test changes using methods such as Plan-Do-Study-Act (PDSA) cycles.

Blais (2021) explains that QI empowers nurses to take an active role in improving their work environment and patient outcomes. Examples of QI in nursing include reducing catheter-associated urinary tract infections (CAUTIs), shortening emergency department wait times, or improving discharge education. Involvement in QI fosters a sense of ownership and professional accountability.

5. Safety

Safety remains a foundational component of nursing practice and was explored in depth in coursework such as NURS 350. This competency emphasizes minimizing harm to patients and providers through both system-level processes and individual performance. It includes identifying risks, preventing errors, reporting near misses, and participating in root cause analyses.

According to Sherwood and Barnsteiner (2017), a key aspect of safety is cultivating a culture of safety, where staff feel comfortable reporting concerns without fear of blame. Medication administration is a prime area where safety is critical. Adhering to the “five rights” (right patient, right drug, right dose, right route, right time) helps prevent adverse drug events. Nurses also play a vital role in infection prevention, fall risk assessment, and monitoring for signs of clinical deterioration.

6. Informatics

Informatics in nursing involves using information technology to document care, support clinical decision-making, improve safety, and communicate effectively. In the digital age, nurses must be proficient with electronic health records (EHRs), bar-code medication systems, and telehealth platforms.

Hebda et al. (2019) argue that informatics is more than just technical skill; it involves understanding how data can be used to improve outcomes and support evidence-based decisions. For instance, tracking patient vitals through electronic charting can help detect early signs of sepsis. Nurses must also be aware of legal and ethical concerns, including patient privacy, data security, and HIPAA compliance.

As healthcare becomes more reliant on technology, informatics competency is no longer optional. Nursing students should be trained to troubleshoot systems, identify data trends, and use technology to enhance—not replace—human connection.

Mastering the QSEN Competencies for Nursing Graduates is essential for safe, high-quality, and patient-focused nursing practice. These competencies—spanning direct care, teamwork, research use, improvement science, technology, and safety—prepare nurses not only to meet today’s challenges but to lead tomorrow’s innovations in healthcare. Embedding these principles in nursing education ensures that graduates enter the field confident, competent, and committed to continuous improvement in the care they deliver.

References

• Blais, K. (2021). Professional nursing practice: Concepts and perspectives (8th ed.). Pearson.
• Clark, C. M. (2015). Creating and sustaining civility in nursing education (2nd ed.). Sigma Theta Tau International.
• Hebda, T., Hunter, K., & Czar, P. (2019). Handbook of informatics for nurses and healthcare professionals (6th ed.). Pearson.
• Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer.
• Sherwood, G., & Barnsteiner, J. (2017). Quality and safety in nursing: A competency approach to improving outcomes (2nd ed.). Wiley Blackwell.